Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation
Malawi is estimated to have achieved its Millennium Development Goal (MDG) 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Ini...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Edinburgh University Global Health Society
2015-12-01
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| Series: | Journal of Global Health |
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| Online Access: | http://jogh.org/pdfviewer.aspx?pdf=documents/issue201502/jogh-05-020412.pdf |
| _version_ | 1818807620326129664 |
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| author | Tanya Doherty Wanga Zembe Nobubelo Ngandu Mary Kinney Samuel Manda Donela Besada Debra Jackson Karen Daniels Sarah Rohde Wim van Damme Kate Kerber Emmanuelle Daviaud Igor Rudan Maria Muniz Nicholas P Oliphant Texas Zamasiya Jon Rohde David Sanders |
| author_facet | Tanya Doherty Wanga Zembe Nobubelo Ngandu Mary Kinney Samuel Manda Donela Besada Debra Jackson Karen Daniels Sarah Rohde Wim van Damme Kate Kerber Emmanuelle Daviaud Igor Rudan Maria Muniz Nicholas P Oliphant Texas Zamasiya Jon Rohde David Sanders |
| author_sort | Tanya Doherty |
| collection | DOAJ |
| description | Malawi is estimated to have achieved its Millennium Development Goal (MDG) 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies.
We performed a retrospective evaluation of the Catalytic Initiative (CI) programme of support (2007–2013). We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST) was used to estimate child lives saved in 2013.
The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI) 189 to 249) in the period 1991–1995 to 119 deaths (95% CI 105 to 132) in the period 2006–2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24%) and increased household coverage of insecticide–treated bednets (19%). These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses.
Malawi provides a strong example for countries in sub–Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community–based delivery platform, can lead to significant reductions in child mortality. |
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| id | doaj.art-09d5e8d99c024d1199b6974a16390336 |
| institution | Directory Open Access Journal |
| issn | 2047-2978 2047-2986 |
| language | English |
| last_indexed | 2024-12-18T19:28:33Z |
| publishDate | 2015-12-01 |
| publisher | Edinburgh University Global Health Society |
| record_format | Article |
| series | Journal of Global Health |
| spelling | doaj.art-09d5e8d99c024d1199b6974a163903362022-12-21T20:55:48ZengEdinburgh University Global Health SocietyJournal of Global Health2047-29782047-29862015-12-015210.7189/jogh.05.020412Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluationTanya Doherty0Wanga Zembe1Nobubelo Ngandu2Mary Kinney3Samuel Manda4Donela Besada5Debra Jackson6Karen Daniels7Sarah Rohde8Wim van Damme9Kate Kerber10Emmanuelle Daviaud11Igor Rudan12Maria Muniz13Nicholas P Oliphant14Texas Zamasiya15Jon Rohde16David Sanders17Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health, University of the Western Cape, Cape Town, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaSaving Newborn Lives/Save the Children, Cape Town, South AfricaBiostatistics Research Unit, South African Medical Research Council, Pretoria, South Africa; School of Mathematics, Statistics and Computer Science, University of Kwazulu-Natal, Durban, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South Africa; School of Public Health, University of the Western Cape, Cape Town, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaInstitute of Tropical Medicine, Antwerp, the NetherlandsSaving Newborn Lives/Save the Children, Cape Town, South AfricaHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaCentre for Population Health Sciences and Global Health Academy, University of Edinburgh Medical School, Teviot Place, Edinburgh, Scotland, UKUNICEF, United Nations Plaza, New York, NY, USAUNICEF, United Nations Plaza, New York, NY, USAUNICEF, Lilongwe, MalawiHealth Systems Research Unit, South African Medical Research Council, Cape Town, South AfricaSchool of Public Health, University of the Western Cape, Cape Town, South AfricaMalawi is estimated to have achieved its Millennium Development Goal (MDG) 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI) programme of support (2007–2013). We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST) was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI) 189 to 249) in the period 1991–1995 to 119 deaths (95% CI 105 to 132) in the period 2006–2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24%) and increased household coverage of insecticide–treated bednets (19%). These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub–Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community–based delivery platform, can lead to significant reductions in child mortality.http://jogh.org/pdfviewer.aspx?pdf=documents/issue201502/jogh-05-020412.pdfChild mortalityreduction |
| spellingShingle | Tanya Doherty Wanga Zembe Nobubelo Ngandu Mary Kinney Samuel Manda Donela Besada Debra Jackson Karen Daniels Sarah Rohde Wim van Damme Kate Kerber Emmanuelle Daviaud Igor Rudan Maria Muniz Nicholas P Oliphant Texas Zamasiya Jon Rohde David Sanders Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation Journal of Global Health Child mortality reduction |
| title | Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation |
| title_full | Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation |
| title_fullStr | Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation |
| title_full_unstemmed | Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation |
| title_short | Assessment of Malawi’s success in child mortality reduction through the lens of the Catalytic Initiative Integrated Health Systems Strengthening programme: Retrospective evaluation |
| title_sort | assessment of malawi s success in child mortality reduction through the lens of the catalytic initiative integrated health systems strengthening programme retrospective evaluation |
| topic | Child mortality reduction |
| url | http://jogh.org/pdfviewer.aspx?pdf=documents/issue201502/jogh-05-020412.pdf |
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